Some of the 16 children discovered in an Ohio home in deplorable conditions could not speak and one, an 18-year-old girl with an intellectual disability, could not even write her name.

After being rescued Tuesday, seven were taken to hospitals, including one who was in critical condition, investigators said. His current conditions were not immediately known Thursday. Child welfare officers have temporary custody of the children.

If what investigators allege is true, it could be the beginning of a difficult path to undo years of abuse, neglect and trauma, and not all foster families can accommodate such serious cases. Ohio also has a shortage of foster families and is becoming more difficult to recruit, as in many states.

Some children may be admitted to specialized treatment centers as part of their recovery.

“It’s going to take a lot of work to address the emotional damage and some of the problems that will result from this,” Ohio Attorney General Andy Wilson said during a news conference this week, adding that he has not seen anything like the conditions the children were subjected to.

“But we need to make sure those children are surrounded, loved and supported by people who really care about them,” she said.

Four people, parents and grandparents of the children, were arrested on charges of child endangerment. Defense attorneys have urged people not to jump to conclusions and wait for the facts of the case to come to light.

Other cases have shown the challenges that lie ahead after children are rescued from horrific conditions of abuse. In one case in Michigan, children were left alone in a home in conditions so offensive that police evidence technicians wore protective suits.

In Southern California, 13 children were rescued from their home in 2018 after being locked up for years and starved to death by their parents.

As in Ohio, the abuse at the Turpin home went unnoticed in the community of Perris, about 60 miles (96 kilometers) southeast of Los Angeles, until Jordan Turpin, then 17, escaped from the home and called the police. When the 13 siblings were rescued, all but the 2-year-old were very underweight and had not bathed in months.

The parents, David and Louise Turpin, pleaded guilty to torture and years of abuse and were sentenced to life in prison with the possibility of parole after 25 years.

The children were subsequently failed at different points by a social services system that was supposed to help them transition to a new life and treat their trauma.

Six of the Turpin brothers went to a foster home where they said they had been abused again. In a lawsuit, they described being beaten with sandals and forced to eat their own vomit. The foster family pleaded guilty in the case and the foster father was sentenced in 2024 to seven years in prison.

A 2022 report by a law firm hired by Riverside County to investigate child care found that the county’s social services system was understaffed and underfunded, leaving workers struggling with high caseloads that made it difficult to ensure safety and care “for our most vulnerable populations.”

Not all foster families have the ability to help in complex cases where children face a multitude of traumas, said Scott Britton, deputy director of the Ohio Public Children’s Services Association.

The system is already overwhelmed: One in four children in Ohio enter foster care not because of abuse or neglect, but because of behavioral health issues, developmental disabilities or involvement in juvenile justice, Britton said.

“We have a lot of children with significant and serious needs, and unfortunately not all of them can be met by a foster family,” she said, noting that residential care facilities and psychiatric treatment centers have to step in. “So unfortunately we are too accustomed to managing a very wide range of significant deficits in children.”

Many states’ child welfare systems are overstretched.

State and federal data show that worker turnover rates can range from 20% to 40% in some locations due to burnout and emotional toll. Recruitment is another challenge as state agencies struggle to attract and retain qualified workers, with rural areas and high-need regions hardest hit.

In New Mexico, the state children’s agency is facing legal action over what the New Mexico Department of Justice has described as systemic failures. He outlined systemic failures in a scathing report released in April, in which the state’s top prosecutor noted the deaths of 14 children over the past two years. Attorney General Raúl Torrez said the circumstances were linked to failures in decision-making and supervision at the Department of Children, Youth and Family.

Ohio has made new investments in children’s services and behavioral health resources, and Britton is hopeful that a statewide Medicaid managed care plan specifically for children and adolescents with significant behavioral health challenges can help.

“I’m not saying it’s enough,” he said. “We could use more and a lot depends on where you are located.”

In California, Riverside County and a foster care agency reached a $13.5 million settlement with the six Turpin siblings placed in an abusive foster home.

Their attorneys said the case helped spur critical improvements in the county’s child welfare system.

Nearly four years after the Turpin children were rescued in California, Jennifer Turpin told ABC News in a 2021 interview that she was ready to move on with her life.

“I want the name Turpin to say, ‘Wow, they’re strong, they’re not broken,’” he said.

He has since published a book about his journey titled “Where Was God?”

Her author bio says: “She’s been through hell and came out strong and resilient.”

__

Watson reported from San Diego and Montoya Bryan from Albuquerque, New Mexico. AP writer Ed White in Detroit contributed.